=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154592244
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLISON EYE M.D.'S PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2008
-----------------------------------------------------
Last Update Date | 05/05/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2700 10TH AVE S STE 402
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35205-1250
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-933-0439
-----------------------------------------------------
Fax | 205-939-1462
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2700 10TH AVE S STE 206
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35205-1248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-933-0439
-----------------------------------------------------
Fax | 205-939-1462
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | SEAN C ALLISON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 205-933-0439
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | MD 28098
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------